Table_1_Cognitive Training Effectiveness on Memory, Executive Functioning, and Processing Speed in Individuals With Substance Use Disorders: A Systematic Review.DOCX

Background: Cerebral neuroplasticity is compromised due to substance abuse. There is damage to neuronal areas that are involved in memory and executive functioning. Treatments with worse outcomes are often associated with cognitive deficits that have resulted from substance dependence. However, there is evidence that cognitive training can lead to improvements in cognitive functions and can be useful when treating addictions. This systematic review aims to synthesize evidence on the effectiveness of cognitive training in memory, executive functioning, and processing speed in individuals with substance use disorder (SUD).
Methods: The Joanna Briggs Institute's PICO strategy was used to develop this systematic literature review. Four databases were searched (PubMed, the Cochrane Library, Web of Science, and PsycINFO) to identify controlled randomized clinical studies and quasi-experimental studies, in English, Portuguese, and Spanish, from 1985 to 2019. The literature found was examined by two independent reviewers, who assessed the quality of studies that met the inclusion criteria. The Cochrane risk-of-bias tool for the randomized controlled trials and the ROBINS-I tool for non-randomized studies were used to assess the risk of bias. In data extraction, the Cochrane Handbook for Systematic Reviews was considered.
Results: From a total of 470 studies, 319 were selected for analysis after the elimination of duplicates. According to the inclusion criteria defined, 26 studies were eligible and evaluated. An evaluation was performed considering the participant characteristics, countries, substance type, study and intervention details, and key findings. Of the 26 selected studies, 14 considered only alcoholics, six included participants with various SUD (alcohol and other substances), three exclusively looked into methamphetamine-consuming users and another three into opioid/methadone users. Moreover, 18 studies found some kind of cognitive improvement, with two of these reporting only marginally significant effects. One study found improvements only in measures similar to the training tasks, and two others had ambiguous results.
Conclusions: The included studies revealed the benefits of cognitive training with regard to improving cognitive functions in individuals with SUD. Memory was the most scrutinized cognitive function in this type of intervention, and it is also one of the areas most affected by substance use.
Systematic Review Registration: [PROSPERO], identifier [CRD42020161039].

背景：由于物质滥用（substance abuse），大脑神经可塑性（cerebral neuroplasticity）会受到损害，参与记忆与执行功能的脑区会出现损伤。预后较差的治疗方案往往与物质依赖引发的认知缺陷相关。不过现有证据表明，认知训练（cognitive training）可改善认知功能，在成瘾治疗中具有应用价值。本系统综述旨在综合分析认知训练对物质使用障碍（substance use disorder, SUD）患者的记忆、执行功能与信息处理速度的改善效果。方法：本系统综述采用乔安娜·布里格斯研究所（Joanna Briggs Institute）的PICO策略构建研究框架。检索1985年至2019年间发表于PubMed、Cochrane图书馆、Web of Science及PsycINFO的英文、葡萄牙语及西班牙语文献，筛选随机对照临床研究与类实验研究。由两名独立评价者对符合纳入标准的文献进行质量评估：针对随机对照试验采用Cochrane偏倚风险评估工具，针对非随机研究则采用ROBINS-I工具。数据提取过程遵循《Cochrane系统综述手册》的规范。结果：初始检索共获得470项研究，去重后筛选出319项进入分析环节。根据预先设定的纳入标准，最终纳入26项研究并进行评价。评价维度包括受试者特征、研究开展国家、使用物质类型、研究与干预细节及主要研究结果。在纳入的26项研究中，14项仅针对酒精使用障碍患者，6项纳入同时存在酒精及其他物质使用障碍的受试者，3项仅关注甲基苯丙胺使用者，剩余3项则针对阿片类药物/美沙酮使用者。此外，18项研究报告了不同程度的认知功能改善，其中2项仅显示边际显著效应；1项研究仅在与训练任务相似的测评指标中发现改善，另有2项研究结果模棱两可。结论：纳入研究结果表明，认知训练可改善物质使用障碍患者的认知功能。记忆是此类干预中研究最为广泛的认知功能，同时也是受物质使用影响最显著的领域之一。系统综述注册：[PROSPERO]，标识号[CRD42020161039]。